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Cited by 1,029Dental Health and Care UtilizationGlobal Public Health Policies and EpidemiologyOral Health Pathology and Treatment

The DOI matches its Crossref record; 101 of the 103 references it cites were found in a registry or an index; 32 of the 117 sources its claims cite were checked for support.

Ending the neglect of global oral health: time for radical action.

Open access
Watt, Richard G, Daly, Blánaid, Allison, Paul, Macpherson, Lorna M D, Venturelli, Renato, Listl, Stefan, Weyant, Robert J, Mathur, Manu R, Guarnizo-Herreño, Carol C, Celeste, Roger Keller, Peres, Marco A, Kearns, Cristin, Benzian, Habib·2019·The Lancet
DOI 10.1016/s0140-6736(19)31133-x
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Abstract

Oral diseases affect over 3.5 billion people globally and oral health systems require radical reform, with dentistry needing greater integration with primary care and broader health systems.

Overview

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(19)31133-x

Cites

101 of 101 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

32 of 117 cited sources checked · 7 supported · 0 flagged · accuracy not yet measured

  • Interpretationcitation

    Dentistry has failed to tackle the global burden of oral diseases.

    “Dentistry however has failed to tackle this problem.”
    • Also stated in: § Key messages · plain
      “Such an approach has failed to tackle the global burden of oral disease; radical reform of dental care systems is now urgently needed.”
    • Also stated in: § Limitations of dentistrya system no longer fit for purpose · hedged
      “Twenty-first century dentistry has largely failed to combat the global challenge of oral diseases.1,10,11”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [1] 1. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 2017;96:380-387. source

      The Discussion reports that oral health did not improve from 1990 to 2015 and calls for greater efforts and possibly a different strategy. The Conclusion says the growing absolute burden of untreated conditions was driven by population growth and aging. These findings support that the global problem remains unresolved, but the paper does not establish that dentistry itself caused or is solely responsible for that failure. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • cites [10] 10. Cohen L, Dahlen G, Escobar A, Fejerskov O, Johnson N, Manji F. Dentistry in crisis: time to change. La Cascada Declaration. Aust Dent J 2017;62:258-260. source
    • cites [11] 11. Vujicic M. Our dental care system is stuck. J Am Dent Assoc 2018;149:167-169.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Interpretationcitation

    Problems in dental training and the mismatch between need and provision of care are compounded by the expansion of specialist practices in dentistry.

    “Problems in dental training and the mismatch between need and provision of care are compounded by the expansion of specialist practices in dentistry.44”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [44] 44. Glick M, Monteiro O, Seeberger GK, et al. FDI Vision 2020 : shaping the future of oral health. Int Dent J 2012;62:278-291. source

      The sections “Shape a responsive educational model” and “Meet the increasing need and demand for oral healthcare” describe shortcomings in dental training and a mismatch between care offered and population needs (page numbers unavailable). The copy does not say that an expansion of specialist dental practices compounds those problems. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Findingcitation

    Households in LMIC face a significantly higher risk of impoverishment or even falling below the poverty line if they have incurred excessive out-of-pocket payments for dental care.

    “Households in LMIC face a significantly higher risk of impoverishment or even falling below the poverty line, if they have incurred excessive out-of-pocket payments for dental care.4”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [4] 4. Bernabé E, Masood M, Vujicic M. The impact of out-of-pocket payments for dental care on household finances in low and middle income countries. BMC Public Health 2017;17:109. source
  • Findingcitation

    Chalkley and Listl identified significant increases in the provision of potentially harmful dental radiographs when dentists received fee-for-service rather than salary payments.

    “Recently, Chalkley and Listl identified significant increases in the provision of potentially harmful dental radiographs when dentists received fee-for-service rather than salary payments.34”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [34] 34. Chalkley M, Listl S. First do no harm -The impact of financial incentives on dental X-rays. J Health Econ 2018;58:1-9. source
  • Premisecitation

    Pay-for-performance systems have shown some potential to improve quality and outcomes of care.

    “Payment and remuneration concepts favouring health outcomes, such as Pay-for-Performance systems, have shown some potential to improve quality and outcomes of care.[84][85][86]”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [84] 84. The World Bank. Project Appraisal Document: Brazil Bolsa Familia Project. Report No. 28544-BR. Washington DC; 2004. Available from: http://documents.worldbank.org/curated/en/792901468770374532/Brazil-Bolsa-Familia-Project (accessed Nov 05, 2018).

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [85] 85. Eichler R. Can "Pay for Performance" Increase Utilization by the Poor and Improve the Quality of Health Services? Washington DC: Center for Global Development; 2009.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [86] 86. Ramji S, Quiñonez C. Public preferences for government spending in Canada. Int J Equity Health 2012;11:64. source

      The Introduction discusses public funding and priority setting, while the Discussion addresses Canadians’ spending preferences; neither reports effects of pay-for-performance on care quality or outcomes. Searches for pay-for-performance and for payment incentives improving care found no relevant passage in our copy. Page numbers were not available. (LLM, conf=0.74)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim. 24
  • It may state two separate claims as one. 51

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Oral diseases affect over 3.5 billion people globally.

    “Oral diseases are a major global public health problem affecting over 3.5 billion people.”
    • Also stated in: § Introduction · plain
      “oral diseases affect over 3.5 billion people across the world”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [1] 1. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 2017;96:380-387. source

  • It may state two separate claims as one.

    Interpretationcitation

    The rapid increases in dentist-to-population ratios particularly seen in certain HMIC are likely to lead to an over-supply of dentists, risk of iatrogenic over-treatment and increasing rates of unemployment amongst dentists.

    “The rapid increases in dentist-to-population ratios particularly seen in certain HMIC are likely to lead to an over-supply of dentists, risk of iatrogenic over-treatment and increasing rates of unemployment amongst dentists.44”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [44] 44. Glick M, Monteiro O, Seeberger GK, et al. FDI Vision 2020 : shaping the future of oral health. Int Dent J 2012;62:278-291. source

      The section “Meet the increasing need and demand for oral healthcare” (page unavailable) reports an over-supply of dentists in some wealthy urban areas. It does not attribute that over-supply to rapid increases in dentist-to-population ratios in certain HMIC, or predict iatrogenic over-treatment or rising unemployment among dentists. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • It may state two separate claims as one.

    Findingcitation

    The global burden of oral conditions has persisted and is likely to worsen.

    “Despite significant scientific developments in our understanding of the pathogenesis and aetiology of oral diseases over recent decades, the global burden of oral conditions has persisted, and is indeed likely to worsen. 1”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [1] 1. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 2017;96:380-387. source

  • It may state two separate claims as one.

    Findingcitation

    In low-income countries, although the overall disease burden is still comparatively low, there are indications that oral diseases are increasing in prevalence.

    “In low-income countries the current situation is most bleak.Although the overall disease burden is still comparatively low, there are indications that oral diseases are increasing in prevalence. 1”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [1] 1. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 2017;96:380-387. source

      The Results (page not available) report increasing oral-condition prevalence and DALYs in 19 of 21 regions, including large DALY increases in several African regions. This supports an indication of rising oral disease, but the cited passages do not establish that prevalence is increasing specifically in low-income countries or that their overall burden is comparatively low. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingcitation

    Untreated dental caries is the most prevalent health condition globally.

    “with untreated dental caries being the most prevalent health condition globally.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [1] 1. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 2017;96:380-387. source

  • It may state two separate claims as one.

    Findingcitation

    Even though dentist-population ratios are only a crude measure of oral health care service availability and there is no correlation to disease levels, the numbers of dental personnel show stark variations across countries, as well as within countries.

    “Even though dentist-population ratios are only a crude measure of oral health care service availability and there is no correlation to disease levels, the numbers of dental personnel show stark variations across countries, as well as within countries.35,36”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [35] 35. FDI World Dental Federation. The Challenge of Oral Diseases -a Call for Global Action. The Oral Health Atlas 2nd Edition. Geneva; FDI. 2015.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [36] 36. Pereira F, de Mendonça I, Werneck R, Moysés S, Gabardo M, Moysés S. Human Development Index, Ratio of Dentists and Inhabitants, and the Decayed, Missing or Filled Teeth Index in Large Cities. J Contemp Dent Pract 2018;19:1363-1369. source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • It may state two separate claims as one.

    Interpretationcitation

    In low-income countries, the 'western' model of dentistry is unaffordable, unsustainable and inappropriate.

    “This is particularly the case in low-income countries where the 'western' model of dentistry is unaffordable, unsustainable and inappropriate.[6][7][8]”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [6] 6. Yee R, Sheiham A. The burden of restorative dental treatment for children in Third World countries. Int Dent J 2002;52:1-9. source

      The Abstract (page unavailable) concludes that traditional restorative treatment of children's caries is beyond the financial capabilities of most low-income nations and says prescribing unaffordable treatment where resources are unlikely to become available is unethical. That supports the affordability and appropriateness concerns, but the paper assesses conventional restorative care for children, not the entire ‘western’ model of dentistry or its sustainability in general. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [7] 7. Baelum V, Van Palestein Helderman W, Hugoson A, Yee R, Fejerskov O. A global perspective on changes in the burden of caries and periodontitis: implications for dentistry. J Oral Rehabil 2007;34:872-906. source
    • cites [8] 8. van Palenstein Helderman WH, Groeneveld A, van der Heijden GJ, van Loveren C, Holmgren CJ, Benzian H. Adequate evidence to challenge the paradigm of dental caries prevention in early age? Am J Public Health 2015;105:e5-6. source

  • It may state two separate claims as one.

    Findingcitation

    The costs of dental treatment can have a major impact on household budgets and wider health care systems.

    “the costs of dental treatment can have a major impact on household budgets 4 and wider health care systems.5”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [4] 4. Bernabé E, Masood M, Vujicic M. The impact of out-of-pocket payments for dental care on household finances in low and middle income countries. BMC Public Health 2017;17:109. source
    • cites [5] 5. Birch S, Listl S. The Economics of Oral Health and Health Care. Max Planck Institute for Social Law and Social Policy Discussion Paper No. 07-2015. 2015. Available from: https://ssrn.com/abstract=2611060 (accessed Oct 20, 2018). source

  • It may state two separate claims as one.

    Findingcitation

    Some countries have recently seen significant increases in numbers of dental schools, many of which are private, for-profit institutions responding to competition and demand for dental courses, with no reflection on the needs of their local populations.

    “Some countries have recently seen significant increases in numbers of dental schools e.g. the USA 37 , Chile 38,39 , India 40 , Brazil 41 and Colombia 42 , many of which are private, for-profit institutions responding to competition and demand for dental courses, with no reflection on the needs of their local populations.43”
    Quote in the paperNot a substantial claim3 of 4 sources checked
    • cites [37] 37. American Dental Education Association. Snapshot of Dental Education 2017-2018. Washington DC; ADA. 2017.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [38] 38. Venturelli Garay RE, Watt RG. Review and analysis of Chilean dental undergraduate education: curriculum composition and profiles of first year dental students. Hum Resour Health 2018;16:48. source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [39] 39. Cartes-Velásquez RA. Exponential growth of dental schools in Chile: effects on academic, economic and workforce issues. Braz Oral Res 2013;27:471-477. source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [40] 40. Jaiswal AK, Srinivas P, Suresh S. Dental manpower in India: changing trends since 1920. Int Dent J 2014;64:213-218. source

  • It may state two separate claims as one.

    Interpretationcitation

    These commercial, for-profit organisations can provide high-quality care, but also need to ensure adequate returns on their investments for their shareholders, and therefore have a tendency for promoting excessive diagnostic testing and over-provision of treatment.

    “These commercial, forprofit, organisations can provide high-quality care, but also need to ensure adequate returns on their investments for their shareholders, and therefore have a tendency for promoting excessive diagnostic testing and over-provision of treatment.10,15,16”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [10] 10. Cohen L, Dahlen G, Escobar A, Fejerskov O, Johnson N, Manji F. Dentistry in crisis: time to change. La Cascada Declaration. Aust Dent J 2017;62:258-260. source
    • cites [15] 15. Bader JD, Shugars DA. What do we know about how dentists make caries-related treatment decisions? Community Dent Oral Epidemiol 1997;25:97-103. source
    • cites [16] 16. Hayashi M, Haapasalo M, Imazato S, et al. Dentistry in the 21st century: challenges of a globalising world. Int Dent J 2014;64:333-342. source

      Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • It may state two separate claims as one.

    Interpretationcitation

    Public oral health care is often the first service to suffer as it is considered to be expensive and not essential, resulting in increased unmet oral health care needs.

    “Public oral health care is often the first service to suffer as it is considered to be expensive and not essential, resulting in increased unmet oral health care needs.[75][76][77]”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [75] 75. Masters R, Anwar E, Collins B, Cookson R, Capewell S. Return on investment of public health interventions: a systematic review. J Epidemiol Community Health 2017;71:827-834. source

      The Introduction says public health is often a politically soft target for budget cuts, supporting the broad point that services may lose funding. It does not identify oral health care as the first service cut, say it is considered expensive or nonessential, or link cuts to unmet oral health care needs (no page number is available in our copy). (LLM, conf=0.78)

      Experimental — accuracy not yet measured
    • cites [76] 76. Zavras D, Zavras AI, Kyriopoulos I-I, Kyriopoulos J. Economic crisis, austerity and unmet healthcare needs: the case of Greece. BMC Health Serv Res 2016;16:309. source

      The Discussion (page unavailable) reports that unmet healthcare needs increased after austerity measures in Greece, mainly because patients struggled to pay for medical care. It does not address public oral healthcare, say that it is the first service to suffer, or attribute cuts to its being considered expensive and nonessential. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [77] 77. Calzón Fernández S, Fernández Ajuria A, Martín JJ, Murphy MJ. The impact of the economic crisis on unmet dental care needs in Spain. J Epidemiol Community Health 2015;69:880-885. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingcitation

    Since 2017 dental amalgam, the filling material central to the restorative approach, is being phased down as part of the United Nations Minamata Convention on Mercury.

    “Indeed, since 2017 dental amalgam, the filling material central to this restorative approach is being phased down as part of the United Nations Minamata Convention on Mercury.63”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [63] 63. Fisher J, Varenne B, Narvaez D, Vickers C. The Minamata Convention and the phase down of dental amalgam. Bull World Health Organ 2018;96:436-438. source

      The paper’s opening section describes dental amalgam as a common restorative material and says the Minamata Convention proposes nine measures to phase down its use. It dates the convention to 2013, but does not establish the claim’s specific starting point of 2017. (LLM, conf=0.85)

      Experimental — accuracy not yet measured

  • It may state two separate claims as one.

    Findingcitation

    Within countries, the poorest quintiles have the lowest coverage rates; in Lao, coverage of the richest quintile is more than 8-times higher than for the poorest.

    “Within countries, the poorest quintiles have the lowest coverage ratesin Lao, in south-east Asia coverage of the richest quintile is more than 8-times higher than for the poorest.29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] 29. Hosseinpoor AR, Itani L, Petersen PE. Socio-economic Inequality in Oral Healthcare Coverage. J Dent Res 2012;91:275-281. source

  • It may state two separate claims as one.

    Findingcitation

    Even though concepts for integrating basic oral health care in primary health care exist, they have failed to gain widespread traction, which further contributes to making access to even basic oral health care a major problem.

    “Even though concepts for integrating basic oral health care in primary health care exist, they have failed to gain widespread traction, which further contributes to making access to even basic oral health care a major problem.[26][27][28]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [26] 26. Frencken JE, Holmgren CJ, van Palenstein Helderman WH. Basic Package of Oral Care (BPOC). Nijmengen; 2002. Available from: http://www.chdentalinstitute.org/images/bpoc.pdf (accessed Oct 10, 2018).

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [27] 27. Chher T, Hak S, Courtel F, Durward C. Improving the provision of the Basic Package of Oral Care (BPOC) in Cambodia. Int Dent J 2009;59:47-52. source
    • cites [28] 28. Kumar S, Ravishankar N, Sumit K, Saran A. Basic package for oral care: relevance and implementation strategies in Indian scenario: a review. Int J Basic Appl Med Sci 2013;3:166-170. source

  • It may state two separate claims as one.

    Findingcitation

    In high-income countries, although overall levels of caries have declined in the child population, the progressive and cumulative nature of the condition into adulthood and older age remains a major problem.

    “In high-income countries where overall levels of caries have declined in the child population, the progressive and cumulative nature of the condition into adulthood and older age remains a major problem.2,3”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [2] 2. Steele J, Clark J, Rooney E, Wilson, T. NHS Dental Services in England: An Independent Review Led by Professor Jimmy Steele. London; NHS. 2009.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [3] 3. Bernabe E, Sheiham A. Age, period and cohort trends in caries of permanent teeth in four developed countries. Am J Public Health 2014;104:e115-21. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Findingnone given

    In many low-income countries few dental schools exist so the supply of dental personnel is very limited.

    “In many low-income countries few dental schools exist so the supply of dental personnel is very limited.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Findingnone given

    Increasingly, in many countries there has been a growth in large corporate bodies and insurance companies that provide health care including dentistry.

    “Increasingly, in many countries there has been a growth in large corporate bodies and insurance companies that provide health care including dentistry.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingnone given

    There is little planning concerning the numbers or distribution of dentists and the wider oral health workforce, nor for the skill sets they require.

    “There is little planning concerning the numbers or distribution of dentists and the wider oral health workforce, nor for the skill sets they require.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingcitation

    Worldwide, there are substantial differences in patient co-payment rates for dental care and this may limit access to and utilisation of care for people on lower incomes.

    “Worldwide, there are substantial differences in patient copayment rates for dental care 31 and this may limit access to and utilisation of care for people on lower incomes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] 31. OECD. Health at a Glance 2013: OECD Indicators. 2013. Available from: https://www.oecd.org/els/health-systems/Health-at-a-Glance-2013.pdf (accessed Oct 15, 2018). ISBN 978-92-64-20502-4

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Findingcitation

    Coverage for oral health care in LMIC is generally lower than in HIC, with median estimations ranging from 35% in low-, 60% in lower-middle, 75% in upper-middle and 82% in high income countries.

    “Coverage for oral health care in LMIC is generally lower than in HIC, with median estimations ranging from 35% in low-, 60% in lower-middle, 75% in upper-middle and 82% in high income countries.29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] 29. Hosseinpoor AR, Itani L, Petersen PE. Socio-economic Inequality in Oral Healthcare Coverage. J Dent Res 2012;91:275-281. source

  • Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.

    Findingreasoning

    Few of these increasing numbers of dentists move into rural and remote, and low dentist/population-ratio areas, so the vulnerable groups with greatest need for dental treatment remain without care.

    “Meanwhile, few of these increasing numbers of dentists move into rural and remote, and low dentist/population-ratio areas, so the vulnerable groups with greatest need for dental treatment remain without care.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Findingnone given

    Oral diseases continue to cause pain, infection and misery for vast numbers of people around the globe.

    “Oral diseases continue to cause pain, infection and misery for vast numbers of people around the globe”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Findingnone given

    In many HIC reform of oral health care systems is often in response to concerns over cost containment rather than more proactive efforts to improve quality of care.

    “In many HIC reform of oral health care systems is often in response to concerns over cost containment rather than more proactive efforts to improve quality of care.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Findingnone given

    Despite advances made by the Cochrane Collaboration and other groups, the lack of evidence for many common dental procedures remains a major challenge.

    “Despite advances made by the Cochrane Collaboration and other groups, the lack of evidence for many common dental procedures remains a major challenge.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingcitation

    While topical fluorides are proven clinical preventive agents, caries will still develop in the presence of free sugars above 10% of total energy intake.

    “While topical fluorides are proven clinical preventive agents, 69 caries will still develop in the presence of free sugars above 10% of total energy intake.70”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [69] 69. Public Health England. Delivering Better Oral Health: An Evidence-Based Toolkit for Prevention. Third Edition.; 2017.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [70] 70. Moynihan PJ, Kelly SAM. Effect on Caries of Restricting Sugars Intake. J Dent Res 2014;93:8-18. source

  • It may state two separate claims as one.

    Findingcitation

    Discussions over scopes of practice and the independence of different professional groups are often complex and fractious, and the debate over which professionals can do what is often decided as a compromise between professional groups rather than with a view to the public's well-being or needs.

    “As with many other professional fields, discussions over scopes of practice and the independence of these different professional groups are often complex and fractious.The debate over which of these professionals can do what, under what circumstances, is often decided as a compromise between professional groups rather than with a view to the public's well-being or needs.50”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50] 50. Canadian Academy of Health Sciences. Improving Access To Oral Health Care For Vulnerable People Living In Canada. Ottawa; CAHS.2014.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Findingcitation

    Current clinical evidence demonstrates that caries is preventable, and once established, may also be reversible, if detected and addressed in the early stages.

    “Current clinical evidence demonstrates that caries is preventable, and once established, may also be reversible, if detected and addressed in the early stages.[58][59][60]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [58] 58. Banerjee A, Doméjean S. The contemporary approach to tooth preservation: minimum intervention (MI) caries management in general practice. Prim Dent J 2013;2:30-37. source
    • cites [59] 59. Fejerskov O. Concepts of dental caries and their consequences for understanding the disease. Community Dent Oral Epidemiol 1997;25:5-12.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [60] 60. Fejerskov O. Changing Paradigms in Concepts on Dental Caries: Consequences for Oral Health Care. Caries Res 2004;38:182-191.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Findingcitation

    The UK National Institute of Health Care Excellence found that there was no scientific basis to the six-month dental recall and recommended that recall intervals should instead be specifically tailored for each patient based on disease levels and disease risk.

    “The UK National Institute of Health Care Excellence found that there was no scientific basis to the six-month dental recall and recommended that recall intervals should instead be specifically tailored for each patient based on disease levels and disease risk.67”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [67] 67. National Institute for Health and Care Excellence (NICE). Dental Checks: Intervals between Oral Health Reviews.Clinical Guideline 19, October 2004. London; 2004. Available from: https://www.nice.org.uk/guidance/cg19 (accessed Oct 15, 2018).

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Findingnone given

    Bold examples from Brazil and Thailand have shown that major reforms are possible and yield positive oral health impacts.

    “Bold examples from Brazil (See appendixpanel 2) Thailand have shown that such major reforms are possible and yield positive oral health impacts.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    Analysis of sales data in selected countries show high growth rates between 2004 and 2017 particularly in China, United Arab Emirates, Russia, Vietnam, Peru, and Indonesia, although sales have also risen steadily in Czech Republic, Colombia, Brazil and South Africa.

    “Analysis of sales data in selected countries show high growth rates between 2004 and 2017 particularly in China, United Arab Emirates, Russia, Vietnam, Peru, and Indonesia, although sales have also risen steadily in Czech Republic, Colombia, Brazil and South Africa (Figure 2).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Figure 2

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Interpretationreasoning

    Dentistry is largely a demand-led service, often poorly planned as a result of entrepreneurial choices, and is therefore poorly aligned to the oral health needs of the local population.

    “Dentistry is largely a demand-led service, often poorly planned as a result of entrepreneurial choices, and is therefore poorly aligned to the oral health needs of the local population.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationnone given

    Fee-for-service payments foster higher utilisation of care but may impede cost-containment.

    “Fee-for-service payments foster higher utilisation of care but may impede cost-containment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    Individualistic, clinical and educational preventive approaches may achieve short-term benefits, but these soon fade unless the underlying causes of disease are tackled.

    “Individualistic, clinical and educational preventive approaches may achieve short-term benefits, but these soon fade unless the underlying causes of disease are tackled.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    In low- and middle-income countries, dentistry is often unavailable, unaffordable and inappropriate to the majority of the population, particularly the rural poor.

    “In many middle-income countries the burden of oral diseases is significant, but oral care systems are often underdeveloped and unaffordable to the majority of the population.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationcitation

    The extent to which patients have to pay or co-pay for dental care and the manner in which dental care providers are reimbursed for their services have important bearings for the utilisation and quality of care.

    “The extent to which patients have to pay or co-pay for dental care and the manner in which dental care providers are reimbursed for their services have important bearings for the utilisation and quality of care.5”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [5] 5. Birch S, Listl S. The Economics of Oral Health and Health Care. Max Planck Institute for Social Law and Social Policy Discussion Paper No. 07-2015. 2015. Available from: https://ssrn.com/abstract=2611060 (accessed Oct 20, 2018). source

  • It may state two separate claims as one.

    Interpretationcitation

    The current individualistic, downstream preventive approach has failed to achieve significant population oral health gain or to effectively tackle inequalities.

    “we also highlight the urgent need to change the individualistic, downstream preventive approach that currently dominates, but which has failed to achieve significant population oral health gain or to effectively tackle inequalities.”
    • Also stated in: § Limitations of dentistrya system no longer fit for purpose · plain
      “This clinical approach to prevention has been unsuccessful at achieving long-term oral health gains or in tackling oral health inequalities.[72][73][74]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [72] 72. Kay EJ, Locker D. Is dental health education effective? A systematic review of current evidence. Community Dent Oral Epidemiol 1996;24:231-235. source
    • cites [73] 73. Watt RG, Marinho VC. Does oral health promotion improve oral hygiene and gingival health? Periodontol 2000 2005;37:35-47.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [74] 74. Harris R, Gamboa A, Dailey Y, Ashcroft A. One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour. Cochrane Database Syst Rev 2012:CD006540. source

  • It may state two separate claims as one.

    Interpretationnone given

    Capitation and salary payments provide good incentives for cost-containment but impose risks of patient selection and/or under-treatment.

    “Capitation and salary payments provide good incentives for cost-containment but impose risks of patient selection and/or under-treatment.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    In low-income countries, investment in oral health is very limited, making dentistry an unavailable and unaffordable luxury reserved for the well-off.

    “With other competing demands on scarce resources, investment in oral health is very limited, making dentistry an unavailable and unaffordable luxury reserved for the well-off.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.

    Interpretationreasoning

    The fault for dentistry's failure lies in the philosophical approach, system and model of dental care delivery, not individual dental clinicians.

    “This is not the fault of individual dental clinicians committed to caring for their patients.The philosophical approach, system and model of dental care delivery are at fault.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationnone given

    In high-income countries, the current treatment-dominated, high-tech, interventionist and specialised approach is failing to tackle the underlying causes of disease and is not addressing oral health inequalities.

    “In high-income countries (HIC) the current treatment-dominated, increasingly high-tech, interventionist and specialised approach, is failing to tackle the underlying causes of disease and is not addressing oral health inequalities.”
    • Also stated in: § Introduction · plain
      “In high-income countries, the current treatment-dominated and increasingly technology-focused system of oral health care is trapped in an interventionist cycle failing to tackle the underlying causes of diseases and not meeting the needs of large proportions of the population.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    Commercial pressures and incentives fuel an interventionist approach and risk unnecessary, and inappropriate care.

    “These commercial pressures and incentives fuel an interventionist approach and risk unnecessary, and inappropriate care.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Premisenone given

    Stark socioeconomic inequalities in oral health mean that poorer and more vulnerable groups in society are particularly affected.

    “Stark socioeconomic inequalities in oral health mean that poorer and more vulnerable groups in society are particularly affected.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationcitation

    This clinical approach to prevention has been unsuccessful at achieving long-term oral health gains or in tackling oral health inequalities.

    “This clinical approach to prevention has been unsuccessful at achieving long-term oral health gains or in tackling oral health inequalities.[72][73][74]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [72] 72. Kay EJ, Locker D. Is dental health education effective? A systematic review of current evidence. Community Dent Oral Epidemiol 1996;24:231-235. source
    • cites [73] 73. Watt RG, Marinho VC. Does oral health promotion improve oral hygiene and gingival health? Periodontol 2000 2005;37:35-47.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [74] 74. Harris R, Gamboa A, Dailey Y, Ashcroft A. One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour. Cochrane Database Syst Rev 2012:CD006540. source

  • It may state two separate claims as one.

    Interpretationreasoning

    The current outdated and treatment-focused approach is failing to meet the oral health needs of large segments of the population, and is totally inappropriate and unaffordable for low-income countries.

    “The current outdated and treatment-focused approach is failing to meet the oral health needs of large segments of the population, and is totally inappropriate and unaffordable for low-income countries.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationcitation

    New developments in adhesive dental materials mean that treatment of established disease, including appropriate use of topical fluorides, may be managed with less destruction of tooth tissue and less need for high technological and rehabilitative dentistry.

    “New developments in adhesive dental materials mean that treatment of established disease, that includes appropriate use of topical fluorides, 61,62 may be managed with less destruction of tooth tissue 58 and less need for high technological and rehabilitative dentistry.12”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [61] 61. Marinho VC, Higgins J, Logan S, Sheiham A. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003:CD002278.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [62] 62. Marinho VC, Higgins JP, Sheiham A, Logan S. Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2004;(1):CD002781

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [58] 58. Banerjee A, Doméjean S. The contemporary approach to tooth preservation: minimum intervention (MI) caries management in general practice. Prim Dent J 2013;2:30-37. source
    • cites [12] 12. Fejerskov O, Escobar G, Jøssing M, Baelum V. A functional natural dentition for all -and for life? The oral healthcare system needs revision. J Oral Rehabil 2013;40:707-722. source

  • It may state two separate claims as one.

    Interpretationcitation

    While a proportion of patients have complex oral health needs requiring additional specialist skills, most oral health needs can be met by primary care dentists and there is some debate as to whether the expansion in specialist dental practices truly reflects and aligns with the oral health needs in the community.

    “While there is no doubt that a proportion of patients have complex oral health needs requiring additional specialist skills, most oral health needs can be met by primary care dentists and there is some debate as to whether the expansion in specialist dental practices truly reflects and aligns with the oral health needs in the community.46”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [46] 46. Mosedale R, Batchelor P. Dental Specialist Lists: Are They Necessary? Prim Dent Care 2012;19:111- 115.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    The WHO-endorsed Basic Package of Oral Care aimed to direct scarce resources for oral health towards evidence-based interventions addressing essential and common needs.

    “The WHO-endorsed Basic Package of Oral Care, which aimed to direct scarce resources for oral health towards evidence-based interventions addressing essential and common needs, must be reviewed and adapted in the light of implementation experience and recent evidence.26”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] 26. Frencken JE, Holmgren CJ, van Palenstein Helderman WH. Basic Package of Oral Care (BPOC). Nijmengen; 2002. Available from: http://www.chdentalinstitute.org/images/bpoc.pdf (accessed Oct 10, 2018).

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Interpretationreasoning

    More of the same will achieve little and is unaffordable in most LMIC.

    “More of the same will achieve little and is indeed unaffordable in most LMIC.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    The described limitations of the prevailing dominant approach in dentistry indicate their complexity, yet also reveal their inadequacy in reducing the global oral disease burden.

    “The described limitations of the prevailing dominant approach in dentistry (See appendixpanel 1) indicate their complexity, yet also reveal their inadequacy in reducing the global oral disease burden.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    Oral diseases and inequalities in oral health are caused by a complex array of individual, social, environmental, economic, political and commercial determinants, mostly shared with other NCDs.

    “Oral diseases and inequalities in oral health are caused by a complex array of individual, social, environmental, economic, political and commercial determinants, mostly shared with other NCDs.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [88] 88. FDI World Dental Federation. Sugars and Dental Caries: A Practical Guide to Reduce Sugars Consumption and Curb the Epidemic of Dental Caries. Geneva; FDI. 2016. Available from: https://www.fdiworlddental.org/sites/default/files/media/resources/sugar_toolkit-fdi-2016.pdf (accessed Sept 15, 2018).

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [89] 89. Yevlahova D, Satur J. Models for individual oral health promotion and their effectiveness: a systematic review. Aust Dent J 2009;54:190-197. source

  • It may state two separate claims as one.

    Interpretationreasoning

    The growth of specialist practice increases the cost of care and access is often sparse in areas of greatest need.

    “The growth of specialist practice increases the cost of care and access is often sparse in areas of greatest need.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationcitation

    The use of clinical preventive interventions such as topical fluorides to control caries is proven to be highly effective, yet is often seen as a panacea and thereby losing sight of the fact that sugar consumption remains the primary aetiological factor in caries development.

    “The use of clinical preventive interventions such as topical fluorides to control caries 59,60,69 is proven to be highly effective, yet is often seen as a panacea and thereby losing sight of the fact that sugar consumption remains the primary aetiological factor in caries development.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [59] 59. Fejerskov O. Concepts of dental caries and their consequences for understanding the disease. Community Dent Oral Epidemiol 1997;25:5-12.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [60] 60. Fejerskov O. Changing Paradigms in Concepts on Dental Caries: Consequences for Oral Health Care. Caries Res 2004;38:182-191.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [69] 69. Public Health England. Delivering Better Oral Health: An Evidence-Based Toolkit for Prevention. Third Edition.; 2017.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.

    Premisenone given

    Simple, cost-effective and equitable interventions exist, as well as population-wide upstream policy measures to reduce risks that are common to NCDs and oral diseases.

    “Simple, cost-effective and equitable interventions exist, as well as population-wide upstream policy measures to reduce risks that are common to NCDs and oral diseases.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationreasoning

    Billions of people are left without access to even basic oral health care.

    “The current public health and health system responses are largely inadequate, inequitable, and costly, leaving billions of people without access to even basic oral health care.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationcitation

    The current state of global oral health is related to inadequate coalescence and leadership among global oral health actors, further widening the disconnect with the wider global health mainstream.

    “The current state of global oral health is hence not only a result of external factors such as competing disease priorities or lack of resources, but also related to inadequate coalescence and leadership among global oral health actors, further widening the disconnect with the wider global health mainstream.106”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [106] source

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationreasoning

    Pricing policies alone cannot deal with the sugar related epidemic; a package of coherent policies are needed.

    “It is important to recognise however that pricing policies alone cannot deal with the sugar related epidemic, a package of coherent policies are needed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Premisenone given

    Oral diseases are a major global public health problem.

    “Oral diseases are a major global public health problem.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.

    Premisecitation

    Oral health is part of the basic human right to health and integral to sustainable human development.

    “Oral health is part of the basic human right to health and integral to sustainable human developmentkey notions of a rights-based approach to global advocacy.35”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] 35. FDI World Dental Federation. The Challenge of Oral Diseases -a Call for Global Action. The Oral Health Atlas 2nd Edition. Geneva; FDI. 2015.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Premisecitation

    The consumption of sweetened commercial baby foods presents a significant risk for early childhood caries, encourages infants to develop a preference for sweetness and may contribute to overweight in later childhood.

    “The consumption of sweetened commercial baby foods is a major concern as this presents a significant risk for early childhood caries, encourages infants to develop a preference for sweetness and may contribute to overweight in later childhood.629 630 631”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [629]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [630]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [631]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. It may state two separate claims as one.

    Premisecitation

    WHO recommends for both children and adults reducing free sugars to less than 10% of total energy intake and a further conditional recommendation that sugar should be less than 5% of total energy.

    “WHO recommends for both children and adults reducing free sugars to less than 10% of total energy intake and a further conditional recommendation that sugar should be less than 5% of total energy.9”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] 9. World Health Organization. Guideline: Sugar Intake for Adults and Children. Geneva; WHO. 2015.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • It may state two separate claims as one.

    Premisecitation

    Commercial baby foods are generally highly processed products often containing high sugar levels.

    “Commercial baby foods are generally highly processed products often containing high sugar levels.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [112]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    Promoting oral health positively contributes to overall development by easing the disease, economic and social burden caused by oral conditions.

    “Promoting oral health positively contributes to overall development by easing the disease, economic and social burden caused by oral conditions.(Figure 4).”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    The processes and politics behind changing global health priorities has been studied and key elements for change have been identified.

    “The processes and politics behind changing global health priorities has been studied and key elements for change have been identified.107”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [107]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationnone given

    The current public health and health system responses are largely inadequate, inequitable, and costly.

    “The current public health and health system responses are largely inadequate, inequitable, and costly, leaving billions of people without access to even basic oral health care.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Premisenone given

    Undeclared and opaque conflicts of interest exist between the sugar industry and certain dental organisations and academic institutions.

    “However undeclared and opaque conflicts of interest between the sugar industry and certain dental organisations and academic institutions need to be addressed (see accompanying Comment).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    The global commercial baby food market is estimated to be worth over US$37 billion in 2010 with Europe, US and Asia holding the major share of the market.

    “The global commercial baby food market is estimated to be worth over US$37 billion in 2010 with Europe, US and Asia holding the major share of the market.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [111]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

66 of 66

  • The paper relies on this without support.

    Sugar, alcohol and tobacco use and their driving social and commercial determinants are the underlying causes of oral diseases and common risks shared with other noncommunicable diseases.

    “Sugar, alcohol and tobacco use and their driving social and commercial determinants are the underlying causes of oral diseases, common risks shared with a range of other noncommunicable diseases (NCDs).”

  • The paper relies on this without support.

    At present the sugar industry is influencing dental research, oral health policy and professional organisations through its well-developed corporate strategies.

    “At present the sugar industry is influencing dental research, oral health policy and professional organisations through its well-developed corporate strategies.”

  • The paper relies on this without support.

    Research focusing on oral diseases is often given low priority by research funding agencies.

    “Research focusing on oral diseases is often given low priority by research funding agencies.”

  • The paper relies on this without support.

    The global drive for universal health coverage provides an ideal opportunity for integrating and reforming oral health care.

    “The global drive for universal health coverage (UHC) provides an ideal opportunity for this.”
    “The growing international momentum towards Universal Health Coverage is a unique opportunity to integrate and reform oral health care.”

  • The paper relies on this without support.

    The sugar industry uses a wide range of corporate strategies to promote sugar consumption and profits and to undermine public health efforts to reduce free sugars consumption.

    “A range of highly developed corporate strategies are used by the global sugar industry to increase their sales and profits, and to undermine public health efforts to reduce free sugars consumption.”

  • The paper relies on this without support.

    In most countries around the world, free sugars consumption is considerably higher than the WHO recommendation, particularly amongst children and young people, and low-income and disadvantaged groups.

    “In most countries around the world, free sugars consumption is considerably higher than the WHO recommendation, particularly amongst children and young people, and low-income and disadvantaged groups.”

  • The paper relies on this without support.

    The introduction of a national sugar levy can have a major influence on industry in reformulating their products reducing the sugar content to avoid price increases.

    “The introduction of a national sugar levy can also have a major influence on industry in reformulating their products reducing the sugar content to avoid price increases as seen in the UK.”

  • The paper relies on this without support.

    Oral health advocates and professional organisations have repeatedly highlighted the neglect of global oral health, without offering a realistic vision about how oral health for half of the world's population can be sustainably improved.

    “So far, oral health advocates and professional organisations have repeatedly highlighted the neglect of global oral health, without offering a realistic vision about how oral health for half of the world's population can be sustainably improved.”

  • The paper relies on this without support.

    The narrow focus of advocating a higher priority for oral health may have deflected resources and efforts from generating a broad consensus among key sector stakeholders.

    “The narrow focus of advocating a higher priority for oral health may have deflected resources and efforts from generating a broad consensus among key sector stakeholders about a joint problem definition, agreement on populationlevel interventions, and approaches to reform and strengthen oral health systems.”

  • The paper relies on this without support.

    Since 1994, the WHO's Global Oral Health programme was scaled-down from a well-staffed unit to a single position at headquarter level.

    “Since then, the WHO's Global Oral Health programme was scaled-down from a well-staffed unit to a single position at headquarter level.”

  • The paper relies on this without support.

    WHO member states also limited their oral health resources or did not even establish national oral health programmes.

    “Such changes were subsequently mirrored by WHO member states who also limited their oral health resources or did not even establish national oral health programmes.”
11 of 11

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In oral health, preventive and minimally invasive interventions such as fluoride varnish application, school-based oral health programmes, ART and community water fluoridation are supported by strong evidence, but their reach, continuity and sustainability remain highly variable across and within countries.

    “In the oral health context, although preventive and minimally invasive interventions—such as fluoride varnish application, school-based oral health programmes, ART and community water fluoridation—are supported by strong evidence; their reach, continuity and sustainability remain highly variable across and within countries.17 18”

    From Mapping evidence on implementation research in oral health: a global scoping review protocol (2026) · cites this paper as [17]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • Oral diseases share risk factors, such as high sugar consumption and tobacco consumption, with cardiovascular disease, cancer, and diabetes.

    “Oral diseases share risk factors, such as high sugar consumption and tobacco consumption, with these 3 noncommunicable diseases.”

    From Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study (2020) · cites this paper as Watt et al. 2019

    The Abstract identifies sugar and tobacco use as causes of oral diseases and says these risks are shared with a range of other noncommunicable diseases. The Introduction also identifies free sugars as a shared risk for dental caries and other NCDs. The paper does not specifically establish the claimed link to cardiovascular disease, cancer, and diabetes individually. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Appendix reference includes an unlisted panel

    Minor

    The text directs readers to appendix panels 3-5, but the list of appendices ends at Panel 4.

  • Baby-food sales figure is numbered inconsistently

    Minor

    The baby-food sales discussion points to Figure 2, but the figure list identifies the sales-growth chart as Figure 3. Figure 2 is assigned to oral health care coverage.

2 of 2

Citations

Cites

Flagged first, then by citations

2 of the 103 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Kumar, 2013, Basic package for oral care: relevance and implementation strategies in Indian scenario: a review, Int J Basic Appl Med Sci, 3, 166
  2. Mosedale, 2012, Dental specialist lists: are they necessary?, Prim Dent Care, 19, 111
  3. 2016, Policy on the dental home, Pediatr Dent, 38, 25

Cited by

Sorted by citations

Related

Metadata

Authors
Watt, R. G., Daly, B., Allison, P., Macpherson, L. M. D., Venturelli, R., Listl, S., Weyant, R. J., Mathur, M. R., Guarnizo-Herreño, C. C., Celeste, R. K., Peres, M. A., Kearns, C., & Benzian, H.
Affiliations
  • University College London (GB)
  • Trinity College Dublin (IE)
  • McGill University (CA)
  • University of Glasgow (GB)
  • Radboud University Nijmegen (NL)
  • University of Pittsburgh (US)
  • Public Health Foundation of India (IN)
  • Universidad Nacional de Colombia (CO)
  • Universidade Federal do Rio Grande do Sul (BR)
  • Griffith University (AU)
  • University of California, San Francisco (US)
  • New York University (US)
Corresponding author
Watt, Richard G
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2019-07
Volume
394
Issue
10194
Pages
261-272
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(19)31133-x
OpenAlex
W2949036829
Cited by
1,029
References
103
Citations by year
2026: 233 · 2025: 159 · 2024: 133 · 2023: 140 · 2022: 118 · 2021: 118 · 2020: 107 · 2019: 17
FWCI
12.70
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Griffith Research Online (submittedVersion, cc-by-nc-nd)
Funders
National Institute for Health and Care Research (NIHR-INF-0386, PB-PG-0212-27029, NF-SI-0515-10032)
Topics
  • Health Sciences › Dentistry › General Dentistry › Dental Health and Care Utilization
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
  • Health Sciences › Dentistry › General Dentistry › Oral Health Pathology and Treatment
Keywords
global oral health, oral health disparities, universal health coverage, low- and middle-income countries, rural poor, sugar consumption, conflict of interest policies, commercial determinants of health, non-communicable diseases, alcohol and tobacco use, oral health equity
MeSH terms
Dental Care, Health Promotion, Humans, Mouth Diseases, Oral Health, Preventive Dentistry, Public Health, Global Health, Health Care Reform, Dietary Sucrose, Food Industry

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Cited sources are checked with a language model’s help (gpt-6-sol).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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